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For Americans there are two main ways to get health insurance coverage which are, individual health insurance plan and group health insurance plan offered by the employer. Those who opt for individual health insurance plan need to pay a monthly or quarterly fee for insurance coverage for the medical attention they need, should the occasion arise. In case the policy holder needs medical attention, the health insurance company pays part or all of the fee, minimizing the amount of medical expenditure. Most Americans are part of group insurance schemes maintained by their employers in which the employer takes care of part or whole of the medical expenditure of the employee. This is the least expensive of all types. There are many types of health insurance plans available in U.S.A now and the major ones are Fee for Service Health Plans,Health Maintenance Organizations,Point of Service Plans, Preferred Provider Organizations and Health Savings Account.

Fee for Service Health Plans are of two types namely basic protection plan and major illness plan. The basic plan takes care of hospital charges when undergoing treatment including surgery and the major plan takes care of long treatment of high cost illnesses. Some health insurance companies combine both these provisions into one which is known as comprehensive plan. The advantage of this type is that you can choose the doctor and the hospital for treatment and you can change the doctors and hospitals if you want. You are required to pay monthly premium and the insurance company pays the hospital charges. You have to check the policy to know which risks are covered since not all charges are covered. You also have to pay part of the charges known as coinsurance which is usually 20% and the remaining 80% is paid by insurance company. In case of claims, you will have to fill up forms along with the purchase receipts of medicine and other treatment charges. Usually there is an upper limit for the amount you will have to pay taking into account your premium and coinsurance. The point to note is that not all health services are covered such as infant care.

Health Maintenance Organization is known as prepaid health plan wherein the medical treatment is provided directly by the doctors working with them and your choice of doctors and hospitals are limited. You may have to pay a small amount for doctor’s visit and emergency care but will be lower than the Fee For Service plan. The benefit of this plan is that you get preventive health care for health issues before they become serious. You are given a card just like credit card that you are required to present at the specified doctor’s office or hospital. The disadvantage of this plan is that you may have to wait for an appointment unlike Fee For Service plan. Before choosing this option it is advisable to inquire about the quality of service rendered by the organization. This scheme arranges for comprehensive medical treatment such as hospital charges, surgery etc for you and your family as per their choice of doctors and hospitals and you are required to pay a monthly premium for the health insurance.

When you use those providers (sometimes called “preferred providers”, other times called “network providers”), most of your medical bills are covered. When you go to doctors in this scheme, you present a card and do not have to fill out forms. Usually there is a small co-payment for each visit. Point of Service Plans is an option offered by Health Maintenance organizations wherein the members are allowed to refer themselves outside this network and still get the insurance coverage provided they pay coinsurance. The preferred provider organization, is a combination of traditional fee for service and an Health Maintenance Organization. Like the Health Maintenance Organization, there are a limited number of doctors and hospitals to choose from.

This scheme requires that you choose a primary care doctor to monitor your health care and also covers preventive care. This usually includes visits to the doctor, well-baby care, immunizations, and mammograms. You can use doctors who are not part of the plan and still receive some health insurance coverage. At these times, you will pay a larger portion of the bill yourself and also fill out the claims forms. Some people like this option because even if their doctor is not a part of the network, it means they do not have to change doctors to join this scheme. For some health care services, you may have to pay a deductible and coinsurance.

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